Heart Failure: Symptoms, Causes, and Treatment

What is Heart Failure: Symptoms, Causes, and Treatment?

Heart failure means your heart isn't pumping as well as it should. This causes symptoms like tiredness, shortness of breath, and swelling in your legs. It often results from conditions that damaged your heart, like high blood pressure or previous heart attacks. While not usually curable, treatments can help manage symptoms and improve quality of life. Your doctor can create a personalized plan with medications, lifestyle changes, and sometimes devices to support your heart.

Symptoms

Early symptoms

• Shortness of breath: Feeling breathless during everyday activities like walking or climbing stairs. You might wake up at night gasping for air. (2) (4) (6)
• Tiredness and fatigue: Feeling unusually tired throughout the day, even after resting or sleeping. Simple tasks may leave you exhausted. (2) (6)
• Swelling in legs and ankles: Noticeable puffiness in your lower legs, feet, or ankles caused by fluid buildup (edema). Your shoes might feel tight. (2) (4)
• Rapid weight gain: Gaining several pounds quickly (3+ pounds in a day or 5+ pounds in a week) from fluid retention. (4) (6)
• Persistent cough: A constant cough that may produce white or pink mucus. It often worsens when lying down. (2) (4)
• Loss of appetite: Feeling full or nauseous after eating small amounts, sometimes with stomach pain or bloating. (4) (5)

Serious or emergency symptoms

• Severe shortness of breath: Extreme difficulty breathing even when resting. You may feel like you're drowning. Call emergency services immediately or go to the nearest emergency room. (3) (5)
• Chest pain: Sudden crushing or squeezing chest discomfort that could signal a heart attack. Call emergency services right away if this is new or different from usual symptoms. (3) (5)
• Irregular heartbeat: Feeling your heart pounding, fluttering, or skipping beats, especially with dizziness. Seek immediate medical care if this is new, worsening, or lasts more than a few minutes. (3) (4)
• Pink, frothy mucus: Coughing up bubbly pink or blood-tinged phlegm, which may indicate fluid in lungs. This is a medical emergency - call for help immediately. (5) (6)

Causes

Primary causes

• Coronary artery disease: Blocked or narrowed heart arteries reduce blood flow, weakening the heart muscle over time. This is the most common cause. (1) (4)
• High blood pressure (hypertension): Uncontrolled high blood pressure makes your heart work harder until it becomes too stiff or weak to pump efficiently. (1) (4)
• Previous heart attack: Damage from a heart attack can leave parts of the heart too weak to work properly. (1) (4)
• Heart valve problems: Damaged or diseased valves can force your heart to work much harder than it should. (4) (5)

Risk factors

Diagnosis

Your doctor will review your medical history, ask about symptoms, and do a physical exam looking for signs like swelling or irregular heart sounds. They'll likely order tests such as blood work to check for heart strain, chest X-rays to see if your heart is enlarged, and specialized heart imaging. An echocardiogram (ultrasound of the heart) is particularly important to see how well your heart pumps. Other tests might evaluate your heart's electrical activity or how it performs under stress.

Treatment

Medication options

Lifestyle and self-care

• Monitor fluid intake: Your doctor may suggest limiting daily fluids if you retain water. Measure all liquids including soups and ice. Use small cups and spread intake throughout the day. (2) (6) (8)
• Reduce salt (sodium): Eating less salt helps prevent fluid buildup. Avoid processed foods, use herbs instead of salt, and check labels for sodium content (aim for under 2,000 mg daily). (2) (6) (7)
• Safe physical activity: Regular, moderate exercise like walking helps strengthen your heart. Start slow and follow your doctor's recommendations about type and amount. (6) (7) (8)
• Daily weight tracking: Weigh yourself at the same time each morning (after using the bathroom, before eating) to catch fluid retention early. Call your doctor if you gain 3+ pounds in a day or 5+ in a week. (10) (9)

Always discuss dosing and treatment changes with your own prescriber.

Possible complications

• Kidney damage: Reduced blood flow can harm kidneys. Some heart failure medicines might affect kidney function too, needing careful monitoring. (5) (9)
• Liver damage: Fluid buildup can increase pressure in liver veins, potentially leading to scarring (cirrhosis). (5) (9)
• Heart rhythm problems: Irregular heartbeats (arrhythmias) can develop, sometimes increasing stroke risk. Some may be life-threatening without treatment. (5)
• Malnutrition: Poor appetite combined with your body's higher energy needs can lead to dangerous weight and muscle loss. (9)

When to see a doctor

Routine follow-up

• Schedule an appointment if you notice new swelling in your legs, more fatigue than usual, or needing extra pillows to sleep comfortably due to shortness of breath. (10) (4)
• Keep regular follow-up visits even when feeling well. Your doctor needs to monitor your condition and may adjust medications. (10) (4)

Seek emergency care

• Call emergency services immediately if you have severe difficulty breathing (especially if you're gasping), chest pain lasting more than a few minutes, or fainting. (10) (4)
• Seek emergency care if you cough up pink, frothy mucus or have a rapid, irregular heartbeat with dizziness. (10) (5)

Frequently asked questions

References

1. CDC — Heart Failure Basics source 1
2. NHS — Heart Failure source 2
3. MedlinePlus — Heart Failure source 3
4. Mayo Clinic — Heart Failure source 4
5. Cleveland Clinic — Heart Failure source 5
6. American Heart Association — What Is Heart Failure? source 6
7. Mayo Clinic — Heart Failure Treatment source 7
8. Cleveland Clinic — Heart Failure Treatment source 8
9. NHS — Living With Heart Failure source 9
10. American Heart Association — Self-Care Guide for Heart Failure source 10